Provider Demographics
NPI:1235487307
Name:YATES, LYNDA KATHRYN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:KATHRYN
Last Name:YATES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:LYNDA
Other - Middle Name:KATHRYN
Other - Last Name:VOHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1850 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-7928
Mailing Address - Country:US
Mailing Address - Phone:561-215-5084
Mailing Address - Fax:863-658-1274
Practice Address - Street 1:111 MEDICAL CENTER AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5423
Practice Address - Country:US
Practice Address - Phone:863-658-2425
Practice Address - Fax:863-658-1274
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA22488225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant